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Adenocarcinoma of the lung is the most common type of lung cancer, and like other forms of lung cancer, it is characterized by distinct cellular and molecular features. [1] It is classified as one of several non-small cell lung cancers (NSCLC), to distinguish it from small cell lung cancer which has a different behavior and prognosis.
Adenocarcinoma in situ (AIS) of the lung —previously included in the category of "bronchioloalveolar carcinoma" (BAC)—is a subtype of lung adenocarcinoma. It tends to arise in the distal bronchioles or alveoli and is defined by a non-invasive growth pattern.
Nearly 40% of lung cancers are adenocarcinomas, which usually originates in peripheral lung tissue. [10] Most cases of adenocarcinoma are associated with smoking; however, among people who have smoked fewer than 100 cigarettes in their lifetimes ("never-smokers"), [ 11 ] adenocarcinoma is the most common form of lung cancer. [ 12 ]
Acinar adenocarcinoma of the lung is a highly lethal disease. Overall, the five-year survival rates approximate 16% to 22%. Generally, survival is better in all stages for patients with the acinar (or papillary) pattern than it is in patients with the solid pattern, but considerably worse than those with the bronchioloalveolar pattern.
Lung cancer is the most diagnosed and deadliest cancer worldwide, with 2.2 million cases in 2020 resulting in 1.8 million deaths. [3] Lung cancer is rare in those younger than 40; the average age at diagnosis is 70 years, and the average age at death 72. [2] Incidence and outcomes vary widely across the world, depending on patterns of tobacco use.
Non-small-cell lung cancer (NSCLC), or non-small-cell lung carcinoma, is any type of epithelial lung cancer other than small-cell lung cancer (SCLC). NSCLC accounts for about 85% of all lung cancers. [1] [2] [3] As a class, NSCLCs are relatively insensitive to chemotherapy, compared to small-cell carcinoma.
Minimally invasive adenocarcinoma of the lung (MIA) is defined as a small (≤3 cm), solitary tumour with predominant alveolar epithelial appearance (lepidic growth), as in situ adenocarcinoma of the lung, with a zone of focal invasion of the stroma with a size inferior to 5 mm. [1] For MIA—as with adenocarcinoma in situ—, the prognosis is near 100% survival.
Most lung carcinomas containing the ALK gene fusion are adenocarcinomas. Some studies suggest that the papillary adenocarcinoma and the signet ring cell adenocarcinoma [5] variants are more likely to carry this fused gene than other histological variants. The median age at diagnosis is around 50 years and the majority are female. [4] [6]